This review aims to summarize the latest advancements in therapeutic strategies for leprosy, focusing on new drug candidates, novel treatment regimens, innovative drug delivery systems, and the ongoing challenge of antimicrobial resistance. Our objective is to provide a comprehensive overview for clinicians and researchers, highlighting promising avenues for improving treatment efficacy, shortening duration, and overcoming resistance. A narrative review of the literature was conducted using PubMed, Google Scholar, and Scopus databases for articles published between 2022 and 2025. Keywords included "leprosy," "Hansen's disease," "bedaquiline," "RIMOXCLAMIN," "drug delivery," "nanoparticles," "post-exposure prophylaxis," and "drug resistance." The therapeutic landscape of leprosy is evolving significantly. Bedaquiline has shown potent bactericidal activity against M. leprae in recent trials, with studies on monotherapy and its inclusion in shortened regimens demonstrating high efficacy. The novel RIMOXCLAMIN regimen has shown superiority over standard multidrug therapy (MDT) in neurological recovery. Concurrently, advancements in drug delivery systems, such as nanocarriers and long-acting injectables, promise to improve patient adherence and treatment outcomes. However, the emergence of resistance to dapsone and rifampicin remains a critical threat, necessitating enhanced surveillance and the development of alternative therapies. Recent research offers considerable hope for transforming leprosy treatment. The integration of new drugs like bedaquiline, optimized regimens, and innovative delivery technologies has the potential to lead to a more effective, patient- friendly, and shorter treatment course. Continued investment in research and global collaboration is essential to translate these findings into clinical practice and accelerate progress towards a world free of leprosy.